The Optune device delivers electric Tumor Treating Fields (TTFields) and has had an established role for the treatment of recurrent and newly diagnosed glioblastoma since receiving FDA approvals in 2011 and 2015, respectively. Where this treatment modality goes from here is currently a subject of intensive clinical investigations. For glioblastoma, TTFields are being combined with stereotactic radiosurgery, hypofractionated radiation, bevacizumab, and/or conventional cytotoxic agents such as temozolomide or lomustine in the recurrent or newly diagnosed setting. These studies will hopefully provide much needed data on ways to improve the efficacy of TTField therapy for use in various combinations in treating glioblastoma. The device is also being applied for the treatment of atypical and anaplastic meningiomas, as well as brain metastases from non-small cell lung cancer. The COMET or EF-21 trial for non-small cell lung cancer brain metastasis is currently recruiting subjects in Europe and the METIS or EF-25 trial is now open in the United States. These studies will provide efficacy data on TTFields for other types of central nervous system tumors. Lastly, extracranial application of the Optune device is being studied in systemic malignancies, such as the PANOVA trial for pancreatic adenocarcinoma and the INNOVATE trial for ovarian carcinoma have completed accrual. In addition, the STELLAR trial for pleural mesothelioma is recruiting subjects in Europe and the randomized phase III LUNAR trial for advanced squamous cell carcinoma of the lung is being planned. These investigations hopefully will provide additional efficacy data on TTFields for various types of extracranial solid tumors.
